Abcc Enrolment Form - 2017 Page 6
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7ACCOUNT NAME:
ABCC Credit Card Authorisation Form
Please complete and return to ABCC to allow fortnightly Permanent Term (Before & After School Care only) payments to be
deducted from your credit card.
I,
, authorise St John’s Anglican College ABCC, to process payment of my ABCC fees as per
the schedule
below.
Signature:
Email address:
Name on Credit Card:
Credit Card No:
/
/
/
Expiry Date:
/
CCV No:
Amount:
$
/ fortnight_
Term 1
Term 2
Date
Amount
Receipt
Processed by
Date
Amount
Receipt
Processed by
7/2/17
2/5/17
21/2/17
16/5/17
7/3/17
30/5/17
21/3/17
13/6/17
4/4/17
27/6/17
Term 3
Term 4
Date
Amount
Receipt
Date
Amount
Receipt
Processed by
Processed by
25/7/17
17/10/17
8/8/17
31/10/17
22/8/17
14/11/17
5/9/17
28/11/17
19/9/17
5/12/17*
To Finalise Term Payments for 2017
•
Office Only
Quote supplied Date___/___/___ by_____________
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St John’s Anglican College ABCC & St John’s EY ABCC
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